Clinical performance of the carbohydrate-deficient transferrin (CDT) assay by the Sebia Capillarys2 system in case of cirrhosis. Interest of the Bio-Rad %CDT by HPLC test and Siemens N-Latex CDT kit as putative confirmatory methods

Gonzalo, Philippe; Pecquet, Matthieu; Bon, C; Gonzalo, Sylvie; Radenne, Sylvie; Augustin-Normand, C; Souquet, Jean-Christophe

doi:10.1016/j.cca.2011.12.022

Cited by 17 publications

(27 citation statements)

References 19 publications

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“…Di-tri bridging was originally observed in the laboratory without detailed clinical data, and was hypothesized to represent a genetic variant (Helander et al, 2001). Although genetic variation could contribute to this pattern, in subsequent case reports it has been associated with significant liver disease (Arndt et al, 2008;Stewart et al, 2010;Gonzalo et al, 2012). The current study confirmed and extended these observations.…”

Section: Discussionsupporting

confidence: 83%

“…Despite its utility in identifying chronic heavy drinking, CDT assay methods have diminished specificity for heavy alcohol use in patients with liver disease and particularly cirrhosis (Heinemann et al, 1998;DiMartini et al, 2001). Case series using the relatively newer HPLC or capillary electrophoresis assays for %dCDT have shown that liver disease can be associated with a diminished chromatographic resolution of disialotransferrin from trisialotransferrin (Arndt et al, 2008;Stewart et al, 2010;Gonzalo et al, 2012), which is the likely cause of this diminished specificity for heavy drinking. This abnormal pattern is due to the presence of higher mass disialotransferrin isoforms resulting from liver-diseaseassociated changes in transferrin glycosylation (Landberg et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Relationship of Abnormal Chromatographic Pattern for Carbohydrate-Deficient Transferrin with Severe Liver Disease

Stewart

Reuben

Anton

2016

Alcohol and Alcoholism

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Aims: Serum carbohydrate-deficient transferrin (CDT) is a validated test for chronic heavy alcohol drinking, but CDT abnormalities have been associated with liver disease, limiting its use in these patients. We report here on the association between poor chromatographic resolution of disialotransferrin from trisialotransferrin (the so-called 'di-tri bridging') and liver disease severity and etiology. Methods: Subjects were patients in whom detailed clinical data, including histology results, were available on their existing liver diseases (n=139). Percent disialo-CDT (%dCDT) was measured by high-performance liquid chromatography, and the risks for di-tri bridging associated with cirrhosis, with and without adjustment for alcohol use and alcohol-related liver disease, were estimated. Results: Di-tri bridging was present in 22/73 (30%) cirrhotic subjects and 7/66 (11%) non-cirrhotic subjects. The unadjusted risk for di-tri bridging in cirrhotics relative to non-cirrhotics was 3.6 (95% confidence interval 1.4-9.2). Adjustment for alcohol-related liver disease and current drinking had little effect on this estimate (adjusted odds ratio 3.4), and neither alcohol-related liver disease nor current drinking were independently associated with di-tri bridging after accounting for the effect of cirrhosis. Conclusions: The presence of di-tri bridging was associated with cirrhosis in individuals with both alcohol-related and non-alcoholic liver disease, although most cirrhotic subjects did not exhibit di-tri bridging. When di-tri bridging is seen in individuals being tested for chronic heavy drinking, investigation for cirrhosis should be considered. Short summary: There are known liver-disease-associated abnormalities in CDT. In this study, we found that such abnormalities were strongly associated with cirrhosis rather than less-advanced disease, but were only clinically evident in 30% of cirrhotics. Abnormalities also occurred in severe hepatitis without cirrhosis and were not specific for liver disease etiology.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Relationship of Abnormal Chromatographic Pattern for Carbohydrate-Deficient Transferrin with Severe Liver Disease

Stewart

Reuben

Anton

2016

Alcohol and Alcoholism

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“…The transferrin glycoform patterns in serum samples from our patients with alcohol dependency and healthy subjects were similar to those in previous reports [20,25,26]. In patients with liver cirrhosis or NASH, the disialotransferrin levels were the same as those in healthy subjects.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of serum carbohydrate-deficient transferrin by HPLC and MALDI-TOF MS

Sogawa

Iida

Kawshima

et al. 2015

Clinica Chimica Acta

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“…78 Our results indicate very a similar performance in a smaller cohort. 71 A sensitivity of 86% with a specificity of 94% was observed for a chronic alcohol consumption higher than 60 g/day, and no significant CDT elevation was observed for daily alcohol consumption lower than 30 g/day.…”

Section: Gonzalo Et Almentioning

confidence: 92%

“…71 In contrast to other glycoproteins, the lack of sialic acid residues in CDT isoforms does not cause their accelerated hepatic clearance via the asialoglycoprotein receptor. 63 Thus, CDT isoforms can accumulate at the plasma level, which is not the case for other serum glycosylated proteins that, as a result, cannot be used as biomarkers of heavy drinking.…”

Section: Gonzalo Et Almentioning

confidence: 98%

Biomarkers of chronic alcohol misuse

Gonzalo¹,

Radenne²,

Gonzalo³

2014

CBF

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Biological markers of chronic alcoholism can be divided into two groups: direct and indirect markers. Direct markers (mainly blood or serum and urine ethanol, ethylglucuronide, ethyl sulfate, and phosphatidylethanol) directly track the intake of alcohol and vary in their sensitivity and kinetics of appearance and clearance. Indirect markers (mean corpuscular volume, γ-glutamyl transferase, alanine aminotransferase and aspartate aminotransferase, and carbohydrate-deficient transferrin) are biological parameters that are influenced by a steady and significant alcohol intake. We discuss the values of these tests and the relevance of their prescriptions for the clinical evaluation of heavy drinking. We indicate, when known, the pathophysiological mechanism of their elevations. We also discuss the amount and time of alcohol consumption required to give a positive result and the duration of abstinence required for the return to normal values. The forensic use of these biomarkers will not be considered in this review.

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Clinical performance of the carbohydrate-deficient transferrin (CDT) assay by the Sebia Capillarys2 system in case of cirrhosis. Interest of the Bio-Rad %CDT by HPLC test and Siemens N-Latex CDT kit as putative confirmatory methods

Cited by 17 publications

References 19 publications

Relationship of Abnormal Chromatographic Pattern for Carbohydrate-Deficient Transferrin with Severe Liver Disease

Relationship of Abnormal Chromatographic Pattern for Carbohydrate-Deficient Transferrin with Severe Liver Disease

Evaluation of serum carbohydrate-deficient transferrin by HPLC and MALDI-TOF MS

Biomarkers of chronic alcohol misuse

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